Lisa Jackson Pulver Muru Marri Indigenous Health Unit UNSW

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Lisa Jackson PulverMuru Marri Indigenous Health
Unit UNSW

• Aboriginal Health

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Acknowledgment of Country
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Introduction

• Life expectancy is very different from
• Nigeria, Nepal, Bangladesh, India, Thailand and
• Indigenous peoples in New Zealand, Canada and
  USA and
• Other Australians.

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Current work

• Asking the primary questions
• How people grow and age
• What is Health
• What is the immediate research need
• Epidemiologic transition theory
• Contrast Aboriginal and non-Aboriginal
  populations
• Examine the appropriateness of this comparison

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What we found

• Mid 20th century epidemiologic transition
• Premature disease and disability
• Population increases and growing younger
• Not ageing as we see in the rest of Australian
  society
• Health, illness and disadvantage cannot be
  explained by SES alone
• Older people are likely to be healthy survivors

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Epidemiologic Transition

• Stage of epidemics
• Extremely high mortality and small
  populationfrom early times up to 1750
• Stage of receding infections Falling infant
  mortality, fertility, younger populationfrom
  about 1750 to 1900s
• Stage of degenerative diseases ZPG, ageing
  populationfrom about 1900 onwards
• Stage of delayed degenerative diseaseDecline in
  systemic disease, ageing of the agedfrom about
  1960s onwards

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Non-Indigenous health

• Social and environmental progress
• For most populations this occurred since 1750s
• Food security
• Includes access, quality, type and choice
• Basic public health
• Water, hygiene, vaccines and medicines, advocacy
• Lower trauma level
• Different patterns now to 100 years ago

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Profile of non-Indigenous Australias population
by age in 1901 and 2000
Source Census of the Commonwealth of Australia,
1911 Population by age and sex, Australian
States and Territories (3201 0)
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(No Transcript)
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(No Transcript)
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Epidemiological transition in Indigenous
populations

• Stage of epidemicsimposed from 1788
• Stage of receding infections 1900 to 1960
• Stage of degenerative diseases 1960 to the
  present
• Stage of delayed degenerative disease
• Not quite there yet

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Indigenous health

• Social and environmental progress
• Education, meaningful employment, housing
• Food security
• Includes access, quality, type and choice
• Basic public health
• Water, hygiene, vaccines and medicines, advocacy
• Lower trauma level
• Safety, both physical and cultural

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What is Indigenous research?

• We collect Indigenous health data by whose
  criteria
• Identification of people
• heart lung disease, trauma, diabetes, renal
  disease
• We study non-indigenous health risk factors
• vascular, obesity, diabetes, trauma, alcohol,
  cigarettes, drugs
• We research provision of health care by organ
  systems
• dialysis, cardiac care, chronic respiratory care,
  diabetes management

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Indigenous health research

• Organ diseases are useful research outcome
  measures
• What are the potentially remediable causal
  factors to address as major research aims for
  Aboriginal Health?

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Interactions of social and physiological
determinants of health.
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Indigenous Australians21st Century

• A 4th transition will take place in the 21st
  century Systemic diseases (heart, lung, renal
  etc) will be delayed and Aboriginal people will
  age successfully
• Aboriginal longevity will increase the gap with
  the non Indigenous community will narrow and
  neuro-degenerative disorders will increase
• However current Aboriginal disadvantage in
  literacy, education, and in factors promoting
  growth, could reduce employment prospects and
  increase disadvantage in the coming generations

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Conclusions

• We need to support traditional areas of research
  - socio-economic, community health, child and
  maternal health and public health research - for
  future Aboriginal generations
• At the same time we need to address - immediately
  and independently - the issues of education,
  basic provision of clean water and fresh food,
  and primary health care, in all Aboriginal
  peoples

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Indigenous health

• .the 20 year gap in life span, compared with
  the non-Indigenous community and with Indigenous
  groups overseas, is a national disgrace which
  requires immediate attention, sustained action
  and on-going national inquiry to seek causes and
  implement solutions
• Australian Association of Gerontology - National
  Newsletter April 2006